How much rates vary
Facilitymedian $457 · 10th to 90th $105 to $3,802Professionalmedian $151 · 10th to 90th $93 to $245
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $117.49 Median $331.13 Typical High $8,317.64 | Facility | None | $117.49 | $331.13 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $151.36 Typical High $323.59 | Professional | None | $93.33 | $151.36 | $323.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,698.24 Median $2,398.83 Typical High $2,951.21 | Facility | None | $1,698.24 | $2,398.83 | $2,951.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $95.50 Median $138.04 Typical High $199.53 | Professional | None | $95.50 | $138.04 | $199.53 |
CareFirst Setting Professional Modifier None Typical Low $79.43 Median $87.10 Typical High $104.71 | Professional | None | $79.43 | $87.10 | $104.71 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $275.42 Typical High $1,621.81 | Facility | None | $102.33 | $275.42 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $162.18 Typical High $251.19 | Professional | None | $102.33 | $162.18 | $251.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $144.54 Median $186.21 Typical High $223.87 | Professional | None | $144.54 | $186.21 | $223.87 |
Medcost Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $263.03 | Professional | None | $218.78 | $218.78 | $263.03 |
Medcost Setting Facility Modifier None Typical Low $93.33 Median $229.09 Typical High $281.84 | Facility | None | $93.33 | $229.09 | $281.84 |
Medcost Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | None | $363.08 | $363.08 | $363.08 |
Sentara Setting Facility Modifier None Typical Low $104.71 Median $371.54 Typical High $2,454.71 | Facility | None | $104.71 | $371.54 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $125.89 Median $234.42 Typical High $933.25 | Professional | None | $125.89 | $234.42 | $933.25 |
United Setting Facility Modifier None Typical Low $100.00 Median $660.69 Typical High $2,041.74 | Facility | None | $100.00 | $660.69 | $2,041.74 |
United Setting Professional Modifier None Typical Low $95.50 Median $162.18 Typical High $275.42 | Professional | None | $95.50 | $162.18 | $275.42 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $46.77 Median $57.54 Typical High $75.86 | Professional | 52 · Reduced service | $46.77 | $57.54 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $22.91 Typical High $30.20 | Professional | 53 · Discontinued | $18.62 | $22.91 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $85.11 Typical High $114.82 | Professional | 54 · Surgery only | $69.18 | $85.11 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $16.98 Typical High $22.91 | Professional | 55 · Aftercare only | $13.80 | $16.98 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $11.48 Typical High $15.14 | Professional | 56 · Pre-op care only | $9.33 | $11.48 | $15.14 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $64.57 Median $79.43 Typical High $107.15 | Professional | 78 · Unplanned return to OR | $64.57 | $79.43 | $107.15 |
Where Virginia sits
The same service costs 3.2 times more in Alaska than in Texas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Virginia· 43rd of 51
$155
AK $427TX $132
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.